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Clinical Topics


Cardiovascular Disease

Better Sleep Metrics Can Identify CVD Risk in Sleep Apnea

MIAMI—Obstructive sleep apnea (OSA) is known to increase the risk of early mortality, stroke, and cardiovascular disease (CVD). A study published in the journal Frontiers in Neurology noted that OSA is defined by the apnea–hypopnea... View Article

Cardiovascular Disease

Previous VA Research Borne Out: PCI Provides No Symptom Relief in Stable Angina

In a move that reanimated a long-standing controversy in cardiology, a recently published study supports and extends the findings of landmark research done by the VA more than a decade ago.

Cardiovascular Disease

INVESTED Trial Tests High-Dose Flu Vaccine for Veterans With Cardiovascular Disease

Influenza hits veterans hard, and older veterans with cardiovascular disease face a substantially increased risk of complications and death from the common ailment.

Cardiovascular Disease

Is Aspirin Really a Wonder Drug for Cardiovascular Prevention?

Since the mid-1980s, aspirin has been used as a preventive drug for cardiovascular disease. In fact, the U.S. Preventive Services Task Force (USPSTF) says that about 40% of American adults over 50 currently take a daily aspirin to prevent heart attacks or strokes.

Cardiovascular Disease

Aggressive Therapy Doesn’t Always Lower Heart Rate in Heart Failure

BOSTON — A single heart rate (HR) measurement could be important in determining future prognosis of chronic heart failure with reduced ejection fraction (HFrEF). Still, according to a recent article in the American Journal of Cardiology, the importance of... View Article

Cardiovascular Disease

Centenarian Veterans Less Likely to Have Heart Failure

WASHINGTON – In general, older patients are more likely to have heart failure than younger ones. That is not true, however, with a group of men 100-years-old or older treated by the VA, according to... View Article

Cardiovascular Disease

How Do Long-Term Heart Failure Patients Differ from Recently-Diagnosed?

DURHAM, NC – How are long-term chronic heart failure (HF) survivors who are hospitalized for acute exacerbation different from patients with more recent HF diagnoses? A study led by Duke University and involving researchers from... View Article

Cardiovascular Disease

VA Study: CV Risks Lower in Patients Taking NSAID, Misoprostol Combo

Use of nonsteroidal anti-inflammatory (NSAID) drugs has been linked to a higher risk of cardiovascular issues, but a new study offers a possible way to mitigate that factor.

Cardiovascular Disease

How Low To Go: The Continuing Controversy on BP Targets

After the release of the SPRINT research in 2015, the question about treating hypertension in older adults appeared to be, “How low can you go?”

Cardiovascular Disease

Fenofibrate Associated With Reduced CV Disease in Diabetics

Cardiovascular risk is increased in patients with Type 2 diabetes, at least partly because of hypertriglyceridemia and low high-density lipoprotein cholesterol.

Cardiovascular Disease

Exercise Capacity Has Strong Effect on Cardiovascular Event Risk

What is the association between exercise capacity and the risk of major adverse cardiovascular events (MACEs)?

Cardiovascular Disease

Statins Lower Amputation, Death Risk in PAD

Statins appear to lower risk of amputation and death in veterans with peripheral artery disease (PAD), according to a recent study.

Cardiovascular Disease

High Mortality for Lower Limb Amputation

While high mortality rates have been reported after major amputations of a lower limb secondary to diabetes and peripheral vascular disease, the mortality rates have varied across studies.

Cardiovascular Disease

Inferior VA End-of-Life Care Reported for Some Noncancer Conditions

Although most patients in the United States die of another condition, cancer is the focus of most end-of-life care studies.

Cardiovascular Disease

Relationship Between AFib, Diabetes Critical to Veteran Care

WASHINGTON—The VA treats about a million veterans for diabetes, nearly one-fourth of its patient population.

Cardiovascular Disease

VA-Led Study: NPs, PA Provide Comparable Cardiac Care to Physicians

All Fail to Consistently Meet Performance MeasuresBy Brenda L. MooneyHOUSTON — Cardiac patients and even some medical staff might assume they will receive the best ongoing care when they see a physician, not an advanced... View Article

Cardiovascular Disease

VA/DoD Recommend More Moderate Approach to Treating High Cholesterol

New Guidelines Significantly Different from AHA/ACC Document

Cardiovascular Disease

Carotid Endarterectomy: Too Much or Not Enough at VA?

By Annette M. BoyleSAN FRANCISCO — For selected patients with carotid stenosis, national guidelines recommend revascularization for primary or secondary prevention of stroke. Increasingly, though, it appears that veterans who could benefit the most from... View Article

Cardiovascular Disease

Staff Shortages Prevent Full Implementation of VA Stroke Directive

Effort Seeks to Standardize Care Across VAMCsBy Annette M. BoyleINDIANAPOLIS — Since the publication of the VHA directive on treatment of acute ischemic stroke (AIS) in November 2011, VA medical facilities nationwide have responded by... View Article

Cardiovascular Disease

Heart Failure Is Latest Serious Health Condition Linked to PTSD

Chronic Conditions Also Associated With Past Combat ExperienceAnnette M. BoyleMINNEAPOLIS — Serious health conditions linked to post-traumatic stress disorder (PTSD) continue to mount. Researchers recently uncovered a significant link between the condition and the risk... View Article

Cardiovascular Disease

Pillbox Program Helps Improve Adherence for Hypertensive Patients

Annette M. BoyleASHEVILLE, NC — Screening, frequent appointments and other interventions enabled the VA by 2010 to bring blood pressure under control in more than three-quarters of patients with hypertension. Helping the remaining one-quarter adhere... View Article

Cardiovascular Disease

Despite Risks, Female Veterans with Heart Disease Less Likely to Receive Statins

HOUSTON — Heart disease is the No. 1 killer of women veterans, yet they remain undertreated

Cardiovascular Disease

Heart Disease Added to List of Health Effects After Experiencing Combat

SEATTLE - While combat has long been known to increase the risk of musculoskeletal injuries, post-traumatic stress disorder (PTSD)

Cardiovascular Disease

VA Tackles Obesity Paradox:

Why Do Overweight Patients Live Longer with Heart Failure? Now the leading cause of hospital admissions in the VA Health Care System, heart failure is associated with high mortality rates and poor quality of life.

Cardiovascular Disease

VA’s COPD Knowledge, Treatment Improving, But Still ‘Tip of the Iceberg’

By Stephen Spotswood WASHINGTON – Chronic obstructive pulmonary disease (COPD) is sometimes referred to as the “quiet” or “silent” killer by clinicians trying to treat it. It presents few symptoms in its earliest stages and... View Article

Cardiovascular Disease

Mortality Rates Drop Dramatically with Wider Use of Anticoagulants

New Formulations Might Be More Effective By Annette M. Boyle BETHESDA, MD – In the last 50 years, the use of anticoagulants has transformed mortality rates for deep vein thrombosis (DVT), pulmonary embolism (PE) and... View Article

Cardiovascular Disease

VA Proposes Physician Pay Increases, Begins Major Recruiting Campaign

By Sandra Basu WASHINGTON – The maximum rates of annual pay for incoming VHA physicians and dentists would be increased as much as $35,000, under a VA proposal announced last month. The updated pay tables... View Article

Cardiovascular Disease

Should Digoxin Be Prescribed for Atrial Fibrillation?

VA Study Latest in Debate about Old Drug’s Safety By Brenda L. Mooney PALO ALTO, CA – A new study is calling into question the practice of treating atrial fibrillation with digoxin, finding that patients... View Article

Cardiovascular Disease

Milwaukee VA Develops Reversal Protocol for Novel Oral Anticoagulants

By Annette M. Boyle MILWAUKEE – Many patients prefer the devil they know. When asked whether they want to go on or switch to a novel oral anticoagulant (NOAC) that requires little monitoring, has few... View Article

Cardiovascular Disease

Stroke Kills Young American Indian/Alaska Natives at Twice Rate of Whites

By Annette M. Boyle ATLANTA – While three-quarters of stroke patients are older than 65, a “brain attack” can affect people of any age. For young American Indians and Alaskan Natives (AI/AN), that information is... View Article

Cardiovascular Disease

Black Servicemembers At More Hypertension Risk, Despite Equitable Healthcare

SILVER SPRING, MD — Military research is raising a new question about an old issue: Why do African-Americans have higher incidence rates of hypertension compared with servicemembers of other races and ethnicities despite equitable access to healthcare within the armed forces?

Cardiovascular Disease

Greater Pharmacist Intervention Tested to Increase Anticoagulant Adherence Rates

By Annette M. Boyle PALO ALTO, CA — Medication is only effective if taken, yet how to make sure patients maintain adherence with anticoagulants and many other long-term medications for chronic diseases poses one of... View Article

Cardiovascular Disease

VA, Army Clinicians Rapidly Increase Prescribing of Novel Anticoagulants

WASHINGTON — Use of novel anticoagulants has risen sharply both at the VA and in the Army in the last three years, freeing more atrial fibrillation patients from food restrictions and regular checks for coagulation time, as required when using warfarin.

Cardiovascular Disease

Female Veterans Develop CVD Risk Factors at Younger Ages

By Annette M. Boyle BOSTON — During the past 15 years, female veterans have developed risk factors for cardiovascular disease (CVD) at ever-younger ages, challenging many providers’ concept of the population at risk for heart... View Article

Cardiovascular Disease

PTSD Linked to Increased Myocardial Ischemia

SAN FRANCISCO — A new study adds to the growing evidence that patients with post-traumatic stress disorder (PTSD) also have increased risks for developing myocardial ischemia.

Cardiovascular Disease

Pharmacist Monitoring Increases Veteran Adherence to ACS Therapy

DENVER — Personalized attention from a pharmacist increases medication adherence in patients to nearly 90% in the year following hospitalization for acute coronary syndrome (ACS), according to a recent study.

Cardiovascular Disease

For Veterans, Acute Kidney Injuries Are More Lethal than Heart Attacks

WASHINGTON — Veterans discharged with a diagnosis of acute kidney injury (AKI) have twice the mortality rate of those diagnosed with myocardial infarction (AMI), yet a lack of awareness and treatment options limit physicians’ ability to manage the condition.

Cardiovascular Disease

Testosterone Therapy Increased Cardiac Events in Veterans after Angiography

By Brenda L. Mooney P. Michael Ho, MD, PhD DALLAS — When considering prescribing androgen deficiency treatment, VA physicians should take into consideration a new study finding that testosterone replacement therapy increased risks of death,... View Article

Cardiovascular Disease

Proteinuria Lowering Can Adversely Affect Some CKD Patients

MEMPHIS, TN — Proteinuria-lowering interventions in patients with advanced chronic kidney disease (CKD) should be implemented cautiously, considering the potential for adverse outcomes, according to a new study led by researchers from the Memphis, TN,... View Article

Cardiovascular Disease

Honored LPN Enjoys ‘Family Experience’ of Working With Veterans

By Steve Lewis Lisa Lang ORLANDO, FL — Lisa Lang, who recently received the 2013 Secretary of Veterans Affairs’ Award for Excellence in Nursing, clearly believes her career is “all in the family.” “My mother... View Article

Cardiovascular Disease

Colorectal Cancer Procedure Wait Times: Deadly Delays or Just Good Medicine?

Martin D. McCarter, MD By Annette M. Boyle DENVER — Are increased wait times at the VA for colorectal cancer procedures because patients are receiving more appropriate care, or are they simply dangerous delays that... View Article

Cardiovascular Disease

Too Little Sleep Raises Women’s Risk of Coronary Events

SAN FRANCISCO – Too little sleep, especially early awakening, plays a significant role in raising unhealthy levels of inflammation among women with coronary heart disease, according to a new study. Interestingly, the elevated inflammation affected... View Article

Cardiovascular Disease

Death at Bronx VAMC Leads to Nationwide Recall of Nuclear Medicine Equipment

By Sandra Basu WASHINGTON – An investigation is ongoing “to determine a definitive cause” of an accident in which a veteran died from injuries sustained when a portion of a nuclear medicine system fell during... View Article

Cardiovascular Disease

New Research Shows Increased Cardiovascular Risks for TBI, PTSD Patients

By Brenda L. Mooney ANN ARBOR, MI – New research on short- and long-term cardiovascular risks from traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) could present significant challenges for the VA and the... View Article

Cardiovascular Disease

VA Study Links Statins to Musculoskeletal Conditions, Injuries

By Brenda L. Mooney DALLAS — Adverse effects from statin therapy go beyond just muscle pain and weakness, also increasing risks of musculoskeletal conditions, arthropathies and injuries, according to a new VA study using a... View Article

Cardiovascular Disease

Atrial Fibrillation Treatment Varies in VA by Who Is Providing Care

By Annette M. Boyle Mintu Turakhia, MD PALO ALTO, CA – Cardiologists may overtreat veterans newly diagnosed with atrial fibrillation and atrial flutter, while primary care physicians may undertreat them, according to research recently published... View Article

Cardiovascular Disease

For example, battlefield conditions ranging from sun exposure to crowded living conditions to chafing and sweating caused by body armor can create hard-to-manage dermatologic issues. This year’s Compendium discusses the unexpectedly high rate of medical... View Article

Cardiovascular Disease

Introduction by Brenda L. Mooney, Editorial Director, U.S. Medicine

“An army is a minature of the society which produces it.”– C.L.R. James Brenda L. Mooney, Editorial Director On a recent road trip to enjoy the spring weather, my husband and I stopped at a... View Article

Cardiovascular Disease

Newly-Approved Anticoagulants Offer More Options, Different Risks

Annette M. Boyle Dr. Alan Jacobson, MD, Director of the anti-coagulation services at the Loma Linda, CA, Veterans Administration Medical Center BOSTON – While newer anticoagulants provide options for many patients with atrial fibrillation (AF)... View Article

Cardiovascular Disease

Surgery May Trump Angioplasty for Diabetes Patients with CAD

INDIANAPOLIS, IN – A new study from the Roudebush VAMC in Indianapolis suggests survival rates are better when diabetes patients with multivessel coronary artery disease receive coronary artery bypass graft (CABG) surgery as opposed to... View Article

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